The experience she garnered from her time as president in 2007 – and her nine years running Salford social services (latterly adult services) – will come in useful as she starts her new job this month as the Department of Health’s learning disabilities tsar for England. Joining things up is very much on her agenda.

“I’ve worked across health and social care locally and nationally, trying to develop seamless services and not getting bogged down by arguments over which bit of the system should pay for what,” Williams says.

The turf war between health services and adult care is a particular issue in the learning disability arena because of the haphazard way in which people’s needs are assessed, services are delivered and national funding is carved up, so that in some instances it’s led by the NHS while in others by social services. Local partnership boards and pooled budgets were meant to overcome this problem, and in many areas they have, but Williams says there is still much to do.

“Individual primary care trusts and hospital trusts have to make it [joint working] happen locally taking into account local conditions,” she says. “Unfortunately, there’s sufficient variation at the moment to say that it isn’t happening everywhere.”

Service inconsistency

This inconsistency in how services are organised and funded in different parts of the country was highlighted in Valuing People Now, the DH’s strategy for developing learning disability services over the next three years.

Williams will oversee the implementation of VPN, which outlined measures to tackle this, including handing local authorities control of NHS learning disability commissioning and funding.

The transfer could be a challenge, Williams says but adds there are signs that VPN has given primary care trusts “a strengthening of focus”, with those areas that have already developed pooled budgets best placed to take advantage of it.

“Following the cases in Cornwall and Sutton the indications are that there is now a high priority for learning disability services in the NHS,” she says. “I think there will be more focus from strategic health authorities than perhaps has been there before.”

At the time of VPN’s release, Williams, then president of Adass, said the transfer of powers was “futile” unless more cash was found to support councils that were “starved of money”. A year on she is less bullish about funding, preferring instead to focus on better use of resources.

“There remains considerable differences across the country in how existing money is being used,” Williams says. “In some places there are large numbers of people in residential care and others placed a long way from their families in expensive placements. It’s important for us to improve commissioning and ensure that best practice is taken on in every area.”

One of Williams’s first tasks in post will be to publish a delivery plan for VPN. It will include the nitty-gritty on how the measures in the strategy – such as expanding job opportunities and improving healthcare – will become a reality for people with learning disabilities. Reforming the systems that monitor services will also be important – new performance indicators for health and housing are being introduced next year.

Boosting the skills of social workers, care staff, nurses and therapists will be key. “We need to keep up the drive for an NVQ workforce and for local training strategies that enable personal assistants to be trained as well,” Williams says.

“Every local authority will be expected to have a training strategy that is joined up with the NHS and voluntary organisations and includes the whole range of staff so that there is the right balance of skills.”

Ambassador for change

Williams’s first-hand experience of how local government and health service work should help her identify potential problems and how to overcome them. Alongside overseeing the practical delivery of VPN she will be an ambassador for people with learning disabilities and their families championing their cause across government.

“I want to deliver things to help people make this happen. I will still be focused on visiting frontline services and hearing people’s experiences so that I get to see where things are working well and where we need to do more to make it happen,” she says.

“In Salford I could make changes to improve things for local people this is an opportunity to do it on a national scale.”

Global crash could thwart aim

The turmoil in the financial markets could plans under Valuing People Now to increase mainstream work opportunities for people with learning disabilities, says Williams.

“It is probably fair to say that when unemployment goes up and economic conditions are difficult it is more challenging to get people into work that may need some extra support at the beginning.

“This is a fantastic aspiration but a challenging target, and while a lot depends on local arrangements and relationships [the credit crunch] may make it more difficult.”

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